Provider Demographics
NPI:1821631110
Name:ASHTON, BRENT ALLEN (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:ALLEN
Last Name:ASHTON
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5815 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-1421
Mailing Address - Country:US
Mailing Address - Phone:419-472-8615
Mailing Address - Fax:419-472-8633
Practice Address - Street 1:5815 SECOR RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-1421
Practice Address - Country:US
Practice Address - Phone:419-472-8615
Practice Address - Fax:419-472-8633
Is Sole Proprietor?:No
Enumeration Date:2019-10-20
Last Update Date:2019-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03439067183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist